[JeremyC]

#28608

Thank you. You have answered most of the questions.

If you don’t mind, could I get your thought on these points:

– One of the only things I can do to relieve the neck and back of head pressure feeling (only very temporarily) is to hang my head over bead (lying on front side). This really pulls/stretches areas that seem to be so tight. Could this be a bad idea if my problems are linked to stretched ligaments? I don’t want to do anymore dammage (obviously).

– In your opinion, could a disorder in the neck area affect sensations in the pallet and cheekbone areas (both sides)?

– “Patients with O-C1 or C1-2 disorders have base of the skull pain that can radiate over the back of the skull.”. I do have base of skull pain (the suboccipital muscles are always tight and painful), and I have abnormal sensations like mild numbness, tingling, and tension/pressure at the back of the skull, but not acute pain or back of head ache. I have an appointment with a pain specialiste on July 11th and will ask him about facet joint blocks for diagnosis purpose as per your recommendation from earlier message.

– “Generally, the most common cause of greater occipital neuralgia is facet disease at C2-3 and C3-4. Facet disease at C1-2 does occur but it is rare. O-C1 disease is even more rare.”. According to the area I feel the pain in, I believe the pinched nerve is the lesser occipital nerve, rather than the greater. Does this fact change your comment?

Thank you.

[Donald Corenman, MD, DC]

#28609

Neck disorders should not cause sensations into the palate and cheekbone as these are serviced by the cranial nerves (which do not exit through the skip into the spine.

Lying face down over the edge of a bed will flex the neck and unload the facets. Pain relief in this position might indicate facet disease as a source of your pain.

I think the facets in the upper neck are a possible source of your pain. A pain consult and facet blocks would be the next step.

Dr. Corenman

PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
 
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.

[JeremyC]

#28615

Thanks, I will definitely mention the facet blocks at the pain consult. However, as I have been diagnosed with Lyme disease, I have read numerous cautions about steroids for patients with Lyme Disease. My layman understanding is that the steroids suppress the immune system which allows the bacteria to multiply and wreak havoc. Are there options for facet blocks that do not involve steroids? If not, would a CT scan be helpful to diagnose upper neck facet dirsorders?

I have abnormal facial sensations that appeared 13 months ago simultaenously with a strong pressure feeling at back of head/upper neck. These are constantly present with only mild fluctuations in intensity. Perhaps this is not linked to neck disorder but Lyme disease. I have been on antibiotics for Lyme disease since October with no improvement so I have my doubts about the Lyme diagnosis. It is unfortunately the only diagnosis I have which could explain all my other non neck related symptoms. The facial sensations are equal on both sides.

I have seen several neurologists for this but they were very dismissive and likely put it down to anxiety, despite the fact that my symptoms are constant and ongoing for over a year and that I don’t feel anxious anymore.

The facial sensations include pressure and mild numbness/swollen feeling. It feels like I have been stung by a bee on my cheeks and have swollen face and slighly numbed skin. I am clueless as to what can be causing this. It appeared on same day as back on head/neck pressure (feeling of a hand pressing on the base of my skull/upper neck).

I feel like I am such an usual case, which makes it very easy for some doctors to dismiss my symptoms as psychosomatic. I have yet to find a neurologist willing to investigate further.

Kind regards,
Jeremy

[Donald Corenman, MD, DC]

#28661

I am unsure where the fascial symptoms originate. If the facial symptoms do not give you fits and you can ignore them for the most part, that is not a bad way to go. If not, I cannot point you in the right direction.

Dr. Corenman

PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
 
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.

[JeremyC]

#31696

Dear Dr. Corenman,
I hope you are doing well since our last exchanges last year. Following these exchanges, I proceeded to have Occipital nerve blocks and pulse radio frequency procedures on left side of neck (C2 to C4 I believe). Unfortunately this has not made any significant difference in my problems. Furthermore, in addition to my neck pains and strong pressure sensation (base of head/upper neck area), I continue to be severely affected by a condition that has not been identified. I understand you must be extremely busy and will get straight to my questions if I may:

– When lying on my back (head on pillow), I often feel significantly worse (malaise, nausea, and also tingling in back and arms). The tension/pressure sensation felt in the upper cervical area is strongest in this position. I am wondering if this could help provide a clue as to the cause of my suffering.

– I have come across the myodural bridge connection and was wondering if you had an opinion about this being a possible cause of neck pain and other symptoms. Perhaps the “bridge” was ruptured during my sports injury 3 years ago.

– As I am suffering from many symptoms without a clear cause found, I have been diagnosed with ME/CFS, although I feel this is a label I have been given by process of elimination (despite that I really don’t feel this diagnosis is correct). Have you heard of Jennifer Brea’s story? She was a “famous” woman diagnosed with ME/CFS, who did a Ted talk and also directed the Netflix Documentary on ME/CFS “Unrest”. Ultimately, it turned out she did not have ME/CFS but some form of upper cervical instability and a cervical fusion resolved nearly all her symptoms. Naturally, I question whether a similar condition could be causing my suffering. Are you aware of her story and do you have an opinion on her case? According to her, there are only 4 neurosurgeons worldwide which diagnose her condition and do the procedure. From memory 2 of them are Dr Gilete in Barcelona and Dr Bolognaise in the USA.

– I have had more physiotherapy sessions than I can count, with no significant improvement. I have so far avoided seeing a chiropractor here in Europe as this has been strongly advised against by most of my doctors including neurologists. In your opinion, who best could I see short of a neurosurgeon? Osteopaths?

Once again, I thank you for the incredible work and support you provide so many desperate people. If you have the time to read and reply to my message I would very much appreciate it.

Kind regards,
Jeremy

[Donald Corenman, MD, DC]

#31784

Myalgic Encephalomyelitis is a condition I have very little experience with. It sounds somewhat like Chronic Fatigue Syndrome associated with Fibromyalgia. I have reviewed the very limited information on PubMed and there really are no diagnostic tests to rely on (similar to Fibromyalgia).

Since this syndrome is not surgically treatable, I would find a neurologist (not a neurosurgeon) who at least has some experience with this disorder.

Dr. Corenman

PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
 
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.

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